Bringing a new baby into the family is an exciting time.  We celebrate the newness of life and have hope for the future.  People are curious about the delivery and the birth story.  Parents are excited and siblings are cautious (at best). 

As everyone swoops in to celebrate the new mother with flowers and wishes for a speedy recovery it is important to pause for a moment and remember the Dad Factor (or the other Mom Factor in lesbian couples).  While initially, there are enough congratulations to go around, the focus inevitably ends on the person who gave birth.  It is important to remember the role the non-gestating parent plays. 

When I work with my parents-to-be, I always remind them that “they” are pregnant.  Even though only one of them has the “joy” of carrying the baby pre-term, they both have important roles to play from the time the baby is conceived.  The investment of both parents starts at that very early time in the process.

Whether it is taking on additional house duties, rubbing lower backs or just deepening personal patience during hormonal flights of fury, the Dad to be is experiencing his portion of the pregnancy.  His excitement, worry, lack of confidence, dreams, etc, are all just as real and important. 

Unfortunately, our society – while having improved – still doesn’t value the Dad role as equally as the Mom role.  Dads don’t get equitable paternity leave from most companies and most Dads don’t take the little paternity leave they are offered!  Many marketing and social constructs are still geared only to Moms and not "parents" or "Moms and Dads".  Until our society moves away from the solid male breadwinner/female caregiver stereotypes, Dads face an uphill battle in having their experience as new parents valued. 

While we need to still push for equal family leave, there are several things we can do as individuals to ensure that Dad (or other Mom) gets their needs met.

1.       Remember there are two parents.  Be sure to ask about the experience of both parents.  Dad will have his own version of the birth story.  After all, watching the person you love go through the experience of childbirth and seeing your child take their first breath fundamentally changes you.  Be sure to acknowledge and celebrate Dad’s experience as much as Mom’s.

2.       Be mindful that midnight feedings, diaper changes, and changes in routine affect the whole family.  Ask Dad his opinion on what would be helpful.

3.       Don’t charge into the family home as soon as the family arrives from the hospital without asking if that is the new parents’ desire.  Often new families prefer to have a private homecoming…to have that moment of coming home as a family be unique to them. 

4.       Don’t criticize Dad’s shortcomings about how to handle a baby.  All new parents need figure it out.  After all, he doesn’t know who this new person is.  He has been waiting a whole pregnancy to finally meet this little one.  Give him time to build a relationship. 

5.       Realize that Dad’s return to work will be challenging for him.  Just as many new mothers are torn about returning to work, Dad can be too.  He may be ambivalent in that he wants to stay home and be a part of the process but also feeling relieved to be at work to get a break from the pressure of figuring out the new routines and responsibilities (and the resulting guilt that may also be present.)

6.       Offer to babysit or provide other care…date night for the new parents is very important!

If you would like to learn more about this topic, contact Elliott Kronenfeld at 617-834-4235 or email him through this site.

Trying to have a baby through third party reproduction is challenging and emotional process.  What makes it even more complicated is that you have to learn a whole new language before you can really make sense of the journey you are about to undertake. Whether you are going through assisted reproduction to create a baby yourselves or need the assistance of others to grow your family, you will need to have some basic knowledge.  There is legal, medical and social terminology that can trip you up…so here is a quick reference guide:

The What:

Artificial Insemination: The deliberate introduction of semen into the vagina (not through ejaculation) in the hopes of achieving
pregnancy.   This can be done in a health clinic or at home.  

Intracervical Insemination (ICI): The deposit of sperm into the cervix with a needleless syringe.  

Intrauterine Insemination (IUI): Washed sperm that is deposited into the uterus.  

In Vitro Fertilization (IVF): A process by which eggs are fertilized by sperm outside the womb in a controlled environment: either a test tube or Petri dish to create embryos. The process is performed by a reproductive endocrinologist at an IVF clinic.

Frozen Embryo Transfer: A process that occurs when a frozen embryo is thawed and transferred into the womb.

Gestational Surrogacy: Pregnancy where an embryo created outside the womb is transferred to a woman who has no genetic tie to the embryo.  The embryo is usually created by the intended parents or with the assistance of an egg and/or sperm donor.  Gestational surrogacy is the most common form of surrogacy in the United States at this time. 

Traditional Surrogacy: Pregnancy where the woman gestating the fetus is genetically related to the child.  This can be result from artificial insemination or IVF.  where the surrogate is genetically related to the baby and becomes pregnant through artificial
insemination. Traditional surrogacy is less common in the United States at this time due to legal concerns. 

The People involved: 

Intended Parent: Person or persons who become the legal parent of a child born through surrogacy.  The intended parents may or may not be genetically linked to the child.  

Carrier/Surrogate/Surrogate Mother:  The general meaning of these words is a woman who carries a baby intentionally carries a baby for intended parents who cannot gestate a baby on their own.  The surrogate may or may not be genetically linked to the child.  It is critical that a contract written by an attorney who specializes in surrogacy is created between the surrogate mother and the intended parents before medical surrogacy process begins. 

Egg Donor: A woman who donates eggs, or oocytes, for assisted reproduction via IVF.  This woman may be a friend, family
member or an identifiable or anonymous donor through an egg donor bank. Like the surrogate, a contract should be written and signed by the intended parents and egg donor prior to any egg donation. 

Sperm Donor: A man who donates sperm.  This man may be a friend, family member or an identifiable or anonymous donor through a sperm bank.  A contract should be in place with the sperm donor and/or sperm bank prior to any fertilization. 

Reproductive Endocrinologist: A doctor who specializes in a subspecialty of obstetrics and gynecology, particularly trained in reproductive medicine and the issue of infertility.  

The How: 

Matching: When the intended parents are matched with the appropriate donors and surrogate.  When using a reputable
agency, social workers are involved to ensure appropriate matches and screening is completed.  

Minnesota Multiphasic Personality Inventory (MMPI-2): A mental health test that is given to egg donors and surrogates as part of the screening process. It identifies personality structure and psychopathology.

Cycle Schedule: A timeline that the monitoring and procedures that lead up to egg retrieval and embryo transfer.  This schedule is determined by the medical team. 

Egg Retrieval: The process by which eggs are removed from the egg donor for fertilization.

Intracytoplasmic Sperm Injection (ICSI): The process by which a single sperm is injected directly into an egg to achieve fertilization.

Preimplantation Genetic Diagnosis (PGD): The genetic profiling of embryos prior to implantation to screen for genetic disease.  Often embryo gender can be identified.

Blastocyst or “Blast”: The last stage of development an embryo must reach before it is implanted in the uterine wall.  This is usually after 5-6 days in an IVF lab.

Embryo Transfer: The process by which embryos are transferred to the gestating woman’s uterus in the hopes of achieving pregnancy.

Beta Testing: A blood test used to help indicate whether a woman is pregnant approximately 10 days after an embryo transfer. It measures levels of Estradiol, Progesterone, LH, and HCG (which indicate pregnancy).

Amniocentesis: A prenatal test used to detect any chromosomal problems through the examination of the amniotic fluid. This test is done between 15 and 20 weeks of pregnancy.

Chorionic Villus Sampling (CVS): A prenatal test performed between 10 and 12 weeks to look at cells in the placenta by inserting a thin flexible tube (catheter) into the uterus though the vagina or by inserting a needle through the belly into the uterus. Similar to an amniocentesis, a CVS procedure is most commonly used to detect Down syndrome, it can detect more than 200 other disorders. .

The Legal: 

Egg Donor Contract: A legal contract between the egg donor and intended parents. The terms of the contract are negotiated by the parties through their legal representation. Once the contract is signed, the terms of the contract govern the parties’ interactions. It is very important for both the intended parents and the egg donor to read the contract carefully so that all conditions are understood.

Carrier Agreement/Surrogacy Contract: A legal contract between the surrogate and intended parents. The terms of the contract are negotiated by the parties through their legal representation. Once the contract is signed, the terms of the contract govern the parties’ interactions. It is very important for both the intended parents and the surrogate to read the contract carefully so that all conditions are understood.

Pre-Birth Order: A court issued order that is acquired before the birth of the child in cases of surrogacy. Typically, it will replace the intended parents' names on the birth certificate.

Post-Birth Order: A court issued order that is acquired after the birth of the child. Typically, it will replace the surrogate with the intended parents on the newborn’s birth certificate.

If you would like to learn more about this topic, contact Elliott Kronenfeld at 617-834-4235 or email him through this site.

What do you do when you have the thing you want  the most and you should be happy but you are miserable? How do you respond when everyone tells you that you “must be so happy!” and you really just want to lie in your bed with the blinds closed? 
You know….those moments that you sit there and think, “I can’t wait for this to be over!”

 Most people idealize the concept of pregnancy.  We expect pregnant women to “glow”, want to nest and turn into some earth-goddess-mother creation.  For many women, that is exactly what happens.  They have easy pregnancies, feel energetic, have complication-free deliveries and look forward to being pregnant again.  Sadly, this isn’t the case for a lot of women.  There are many women who spend their pregnancy praying at the porcelain throne, gagging as they force themselves to eat, feel the bottom drop out as their energy slams into the basement and the only glow they experience is from the TV because they can’t get sleep…and then they feel guilty for not being the “glorious mother-to-be” that everyone expects them to be. 
 
So…the purpose of this little discussion is not to scare anyone, but rather to set some appropriate expectations.  It would be ideal if every pregnancy was a joyful ride to post-partum, but some just are not.  If you are experiencing a pregnancy that is less than ideal…it is okay.  If you are feeling less than joyful…it is okay.  You have permission to not love pregnancy. In fact, you have permission to really, REALLY dislike it!  There. I said it.  You have the right to be a normal, pregnant person and not enjoy the process without it making you a bad person or an unfit mother.  After all, the goal is not to be pregnant.  The goal is to have a healthy baby that you can love and nurture.  The pregnancy phase is the work that you do to get to the end prize!  
 
How you experience pregnancy will have no reflection on how you will parent, love your child and provide for his or her needs.  However, your ability to have good self-care and release yourself from judgment will be an indicator on how you can affect the challenges of pregnancy.  Be kind to yourself.  Talk to your partner, family and support system.  Don’t listen to negative commentary about what you should be doing and feeling at this phase. Know that your pregnancy is completely unique and should not be compared to anyone else’s (even your own if this isn’t your first.)  If you can, exercise…even a small walk in the sunshine can help.  Remember, the goal isn’t to have a perfect pregnancy.  The goal is to have  a healthy baby. 
 
If you would like to know more about this topic, contact Elliott Kronenfeld at 617-834-4235 or email him on this site. 

Do you ever find yourself avoiding people that you feel close to because you have a truth about yourself that you are afraid to share? In my practice I work with lots of people who are on a path of self-discovery and trying to live a life with integrity. This journey often brings new truths and/or challenges to important relationships because being open and honest about something that feels emotionally charged is scary. Sometimes it is about their identity (such as coming out as gay) or a desire (perhaps changing career or having children) or an emotional challenge (changing relationship). Whatever the issue, talking to others about it can raise anxiety, fear of judgment, rejection and loss.

When they finally find the right time to discuss the issue with family and friends, I hear things like “They will think I am crazy!” or “What if they think that everything I told them before was a lie?” or “They are going to be so angry and not talk to me anymore.” As I continue to work with them, I often remind them that they have had the luxury of time to think about the issue and gain some perspective, even if it still feels scary and uncomfortable. Helping them to remember that their supporters are just getting this information for the first time – even if they already suspected and are just getting confirmation – is an important step.

More often than not, people are surprised at just how accepting and open others can be. When they realize that the build-up was bigger than necessary, each coming declaration gets easier. However, if there is a reaction that is less than openly accepting, it is difficult not to personalize it. My advice in that moment is simple: QTIP! Quit Thinking It’s Personal!

People have to own their reactions. If someone has a reaction that is less than what you had hoped for, it isn’t about you. Negativity, anger, frustration, rigidity is about them and how they are reacting to your truth about yourself. They have to work through the new information, formulate new expectations, process through old understandings and try to understand what the new normal is. This may require a great deal of additional information, self-disclosure and support from you in the face of a seemingly lack of support. Again, remember you have been living with this knowledge for longer than they have!

Being able to remember that the end goal is to bring the relationship to a more open and connected place should be the guiding motivation. This might mean living through some difficult conversations, periods of adjustment and relearning how to connect. However, with guidance and understanding, you can be living more truthfully and openly with those you love.

If you would like to learn more about this topic, contact Elliott Kronenfeld at 617-834-4235 or email him through this site.

If you are a gay man, woman or couple who is considering adding children to your life, this is an exciting time!  There are more and more examples of  gay men and women who are becoming parents through methods other than through  previous heterosexual relationships.  How to achieve this dream, can be  overwhelming without a lot of information and forethought.
 
There are several decisions to be made as you begin your process to  parenthood.  Here is a list of some, but not all, of the topics to be  discussed:

1. How out are you?  Do you feel comfortable with everyone knowing that  you are GLBTQQI?  The truth of the matter is that being a gay parent  requires that you find a sense of normalcy within your family/community.  Children will talk about their family and home.  Descretion is a learned  skill!  When you can normalize your sexual orientation and relationship,  you children will take your lead.  If you are uncomfortable with people knowing that you are not heterosexual, your children will internalize your concerns.
2. How will your social supports change?  Do you know lots of people with children or are you the first in your social circle to bring children into your  life?  Many first time parents are shocked when some social friends are not as welcoming of children as others.  Can you imagine yourself making new  friends in the tot lot?  Who do you think they will be?  What will that mean to you?
3. What is the role of biology?  Are you considering using your own biology (surrogacy, IVF, insemination, etc) or are you planning for  adoption?  What does it mean when one partner is genetically linked to a child but the other partner isn’t?  Will you need a sperm or egg  donor?  How will you choose?  If you choose adoption, what is the role your child’s birth family?  Understanding the difference between biological  parent and Mother/Father is an important distinction.
4. How will you manage your financial planning.  As openly gay parents to be, the cost of bringing a child into your life can range from a few hundred dollars to well over $100,000.  What process works best for you, and how you pay for it, needs to be considered as you decide to move forward.  Each process has its own benefits and challenges.  Make sure you understand the what is required and how much each step costs!
5. What legal protections will you need?  Based on where you live, your marital status and the biological root of your child will determine what legal processes you will need to preserve the appropriate protections for every member of your family.

There are many more considerations to ponder.  Be sure to talk to a specialist who understands the route to building a gay/lesbian/trans family.  Regardless of what route is best for you, be sure to think long term (What impact will these early decisions have on my child/family years from now?  What does my family look like when it is complete?) and keep as many
options on the table for as long as you can — you never know what the future brings!

As small children we role play as adults. We are explorers, teachers, doctors,  police officers, presidents. Most often we are mommies and daddies. Children are  socialized from the earliest moments to aspire to be like their parents and have  children of their own. Occasionally, as children grow up to adults, they decide  that they don’t want children, and that is a fine decision. However, for those  that want children and have difficulty having them, it is a devastating reality. 

This reality forces us to redefine our sense of self…our very identity. In turn, this can produce a sense of loss – mourning the future that we thought was ours.  While there may still be options, the story book ideal of the magical pregnancy, created and shared in love is shattered as medical professionals, family and  friends begin to weigh in and discuss the most intimate aspects of your life.

 No two people ever experience infertility the same the way. This is an extremely personal journey. Often, those living with infertility feel like the only person on the planet and that no one would understand, even those closest  to them. If you (and your partner) are living with infertility for any reason, the first step is to have a full medical work up by a fertility specialist. It is also extremely important to ensure that you have adequate emotional supports which may include a therapist who specializes in fertility issues.

Infertility can have many root causes such as medical diagnosis/treatment, loss of reproductive organs, unexplained infertility, multiple losses or simply due  to increased age. Often, a couple will be able to have an easy and successful  pregnancy and then struggle with secondary infertility (difficulty conceiving a  second or subsequent pregnancy). This can be particularly frustrating and  upsetting if the first pregnancy was so easy. Wanting to grow your family and  struggling to do so can pull focus from the rest of your life. If you are not  careful, you can become stagnated and begin struggle as you try to move  forward.

 Living with infertility can become isolating if not managed. Are you having difficulty attending baby showers or celebrations of others’ growing  families? Do you feel increased resentment or guilt? Do you find yourself  pulling away? It can be so difficult for others to understand that your sadness  is not in relationship to the happiness you feel for them, even though it may be
difficult for you to share it.

 Infertility can also cause marital woe. It is  important to remember that infertility does not happen to an individual person,
it happens to a couple. Often, one partner may feel guilty or can feel blamed.  It is important to be able to remain a unified team and to understand the root causes and possible solutions to your family building. Infertility can also  be a result of other medical conditions. In many situations, there is an option  of preserving your fertility before undergoing medical treatment. It is  important to ask your medical care team if your fertility is at risk and what options are available to you prior to treatment. There are many solutions to infertility, including ones that you may not have thought about yet. Keep hope.  Seek resources. Take good care of yourself!